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Washington DC
#1
What is the deal with programs in Washington DC? Anyone who has rotated or had any experience with them have any thoughts?
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#2
Excluding Walter Reed and NIH, there's Georgetown, GWU, Inova. As someone who went to med school at one of these programs and interviewed at the other ones here are my thoughts -
Georgetown probably has the best overall experience in terms of case volume, research opportunities, and autonomy. They start operating early and progress rapidly. Down side is the case volume and complexity means most residents stay late operating. Their call is bottom heavy with the intern taking most of the call and it can get busy with typically more than 50 patients on their service. They rotate at Washington Hospital Center which is the main Level 1 trauma center in DC and get a lot of their vascular experience there too. Their strongest component is probably spine, especially MIS.
GWU is a smaller program and from my impression, residents didn't seem too happy there. I think they're also in transition with their Chair having left recently as well as a couple of other attendings. Don't know much about Inova since it's relatively new. They did a good job selling the program during the interview and seem to have a lot of mid-level support, which frees up time for operating.

TLDR: if I had to chose one to go to, it would be Georgetown.
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#3
Georgetown dosn't have good autonomy, attentings were pretty much hands-on in most cases even ACDFs
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#4
(08-18-2020, 11:03 PM)Guest Wrote: Georgetown dosn't have good autonomy, attentings were pretty much hands-on in most cases even ACDFs

"Even ACDFs", most attendings at most institutions are especially hands on in ACDFs. It's an elective procedure in usually a generally healthy population that can be delicate and have terrible complications. PCDFs, lumbar lamis etc make sense to be hands-off, not ACDFs.
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#5
(08-19-2020, 08:38 AM)Guest Wrote:
(08-18-2020, 11:03 PM)Guest Wrote: Georgetown dosn't have good autonomy, attentings were pretty much hands-on in most cases even ACDFs

"Even ACDFs", most attendings at most institutions are especially hands on in ACDFs. It's an elective procedure in usually a generally healthy population that can be delicate and have terrible complications. PCDFs, lumbar lamis etc make sense to be hands-off, not ACDFs.

^Agreed. It is so blatantly obvious when someone has no idea what they're talking about on this forum...
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#6
(08-19-2020, 08:57 AM)Guest Wrote:
(08-19-2020, 08:38 AM)Guest Wrote:
(08-18-2020, 11:03 PM)Guest Wrote: Georgetown dosn't have good autonomy, attentings were pretty much hands-on in most cases even ACDFs

"Even ACDFs", most attendings at most institutions are especially hands on in ACDFs. It's an elective procedure in usually a generally healthy population that can be delicate and have terrible complications. PCDFs, lumbar lamis etc make sense to be hands-off, not ACDFs.

^Agreed. It is so blatantly obvious when someone has no idea what they're talking about on this forum...

Med students acting like ACDFs are a walk in the park, apparently PGY-2s do their ACDFs. Half of their elective patients end up requiring PEGs but it's ok because "aUtoNOmY"
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#7
(08-19-2020, 08:57 AM)Poin Guest Wrote:
(08-19-2020, 08:38 AM)Guest Wrote:
(08-18-2020, 11:03 PM)Guest Wrote: Georgetown dosn't have good autonomy, attentings were pretty much hands-on in most cases even ACDFs

"Even ACDFs", most attendings at most institutions are especially hands on in ACDFs. It's an elective procedure in usually a generally healthy population that can be delicate and have terrible complications. PCDFs, lumbar lamis etc make sense to be hands-off, not ACDFs.

^Agreed. It is so blatantly obvious when someone has no idea what they're talking about on this forum...

Lol! Clearly you haven’t rotated in a program in the South, where ACDFs are comfortably done by PGY2/3 and senior residents actually do skull base/aneurysms.
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#8
"Call me when you need me"

The usual comment from 90% of our staff in ACDFs. Come train with us and you will be comfortable doing them on your own. So, no, staff are not hands-on in ACDFs in all programs, and this does not translate into higher rates of esophageal injuries/PEGs, inadequate decompression, cord injury or CSF leaks, etc. Can't guarantee though that the plate is going to look dead straight on AP Smile

PGY4, Midwest. (The South is more or less the same)
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#9
(08-19-2020, 06:50 PM)Guest Wrote: "Call me when you need me"

The usual comment from 90% of our staff in ACDFs. Come train with us and you will be comfortable doing them on your own. So, no, staff are not hands-on in ACDFs in all programs, and this does not translate into higher rates of esophageal injuries/PEGs, inadequate decompression, cord injury or CSF leaks, etc. Can't guarantee though that the plate is going to look dead straight on AP Smile

PGY4, Midwest. (The South is more or less the same)

Does the attending help with your washout?
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#10
(08-19-2020, 07:37 PM)Guest Wrote:
(08-19-2020, 06:50 PM)Guest Wrote: "Call me when you need me"

The usual comment from 90% of our staff in ACDFs. Come train with us and you will be comfortable doing them on your own. So, no, staff are not hands-on in ACDFs in all programs, and this does not translate into higher rates of esophageal injuries/PEGs, inadequate decompression, cord injury or CSF leaks, etc. Can't guarantee though that the plate is going to look dead straight on AP Smile

PGY4, Midwest. (The South is more or less the same)

Does the attending help with your washout?

No takebacks yet. Hopefully you'll learn how to do them well during your second fellowship.
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